Further insight into the pathophysiology of MS was provided by Eduard Rindfleisch, a 19th century German pathologist, who analysed post-mortem brain samples from MS patients.
In 1863, Rindfleisch reported a key finding that paved the way for theories of inflammatory involvement in the aetiology of MS. He noticed that, consistently in all the specimens, a blood vessel was present at the centre of each lesion. His illustrations of the plaques are seen in the slide.
"If one looks carefully at freshly altered parts of the white matter ... one perceives already with the naked eye a red point or line in the middle of each individual focus,.. the lumen of a small vessel engorged with blood ... All this leads us to search for the primary cause of the disease in an alteration of individual vessels and their ramifications; All vessels running inside the foci, but also those which traverse the immediately surrounding but still intact parenchyma are in a state characteristic of chronic inflammation." [/b]
He looked at MS brains with a microscope, and could see that inside each lesion was a vein engorged with blood. He believed the primary cause of MS was whatever altered those vessels. It has taken 140 years to look at the jugular veins as the source of venous congestion, even after all we know about venous congestion in other organs of the body. I'm sorry, but why the hell has it taken so long?